In Office Dental Plan

​The In-Office dental plan is an alternative for businesses, families or individuals, who want excellent dental health coverage without the barriers of a traditional dental insurance:- No waiting periods - No large annual maximums - No pre-existing conditions exclusions - No hassle dealing with insurance companies

SERVICES INCLUDED IN THE YEARLY MEMBERSHIP:

Basic: · Yearly x-rays including a full mouth series taken every 36 months · Two Periodic Examinations per year · Two Routine Oral Prophylaxis per year (prophylaxis only, not advanced hygiene services such as scaling and root planning or full mouth debridement) · Fluoride treatments for kids are limited to once per calendar year, until the age of 14.

Periodontal:

Yearly x-rays including a full mouth series taken every 36 months

Two Periodic Examinations per year

Two Routine Oral Prophylaxis per year

Two Periodontal Maintenance cleanings per year

REDUCED FEES: All dental services are offered at 15% less than the normal office fees. Payment for the above services is due at the time of service, and all payments are made directly to Lena D. Karkalas DDS.

ELIGIBILITY: Anybody is qualified to apply for our In–Office Dental Plan. Participants are eligible upon payment of the enrollment fee. This plan is administered solely by this dental office and may be discontinued at the end of any month, with or without notice.

Membership in the Dental Plan may be terminated if the member misses multiple appointments, or for abuse and failure to pay membership fees or properly billed work. Missed or broken appointments without 48-hour notice will be charged $70.

PLAN LIMITATIONS AND EXCLUSIONS : Dental Services not provided by our practice are not covered by this plan, even if they are recommended by our office, such as referrals to specialists.

Any dental procedures in progress or performed before or after a member’s eligibility period is excluded.

Any dental services provided to the member by the state, county, or municipal agencies, or dental services provided without cost to the member is excluded.

Dental plan discounts for dental services provided in association with benefits received from an alternate source (i.e. Worker’s Compensation or In Network insurance) is excluded.

Our plan is offered to patients who either do not have dental insurance coverage, or their current insurance benefits have been used for the calendar year. When a member chooses to use their dental insurance coverage to pay for the services, the dental insurance plan rates, payments, Copay and deductible will apply NOT those listed in our plan.

CANCELLATION: Unless waived by the dentist, membership will automatically renew on the anniversary date and will continue thereafter until cancelled in writing. Cancellation should be sent 30 days prior to the expected day of cancellation. If the plan was cancelled by the dentist, the membership fee will be refunded to the memberOnce The first service is rendered a refund is not possible. We will try to work with the member as best we can.